Comparison of A1C and Fasting Glucose Criteria to Diagnose Diabetes among U.S. Adults
- April P. Carson, Ph.D. (apcarson{at}uab.edu)1,
- Kristi Reynolds, Ph.D.2,
- Vivian A. Fonseca, M.D.3 and
- Paul Muntner, Ph.D.1
- 1Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL
- 2Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA
- 3Scott and White Clinic, Texas A & M Health Sciences Center, Temple, TX
Abstract
Objective: To compare glycosylated hemoglobin (A1C) and fasting glucose for the diagnosis of diabetes among U.S. adults.
Research Design and Methods: This study included 6890 adults (≥20 years) from the 1999-2006 National Health and Nutrition Examination Survey without a self-reported history of diabetes who had fasted ≥9 hours. A1C ≥6.5% and fasting glucose ≥126 mg/dl were used, separately, to define diabetes.
Results: Overall, 1.8% of U.S. adults had A1C ≥6.5% and fasting glucose ≥126 mg/dl, 0.5% had A1C ≥6.5% and fasting glucose <126 mg/dl, and 1.8% had A1C <6.5% and fasting glucose ≥126 mg/dl. Compared to those with A1C <6.5% and fasting glucose ≥126 mg/dl, individuals with A1C ≥6.5% and fasting glucose <126 mg/dl were younger, more likely to be non-Hispanic black, had lower hemoglobin levels, and higher C-reactive protein.
Conclusions: A1C ≥6.5% demonstrates reasonable agreement with fasting glucose for diagnosing diabetes among U.S. adults.
Footnotes
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- Received July 6, 2009.
- Accepted September 21, 2009.
- Copyright © American Diabetes Association
